CMS-HCC Risk Adjustment · V28 Model · Payment Year 2026 95 Codes

HCC 249: Ischemic or Unspecified Stroke ICD-10-CM

CMS-HCC Category 249 (Ischemic or Unspecified Stroke) is a payment HCC in the V28 Medicare Advantage risk adjustment model. For payment year 2026 it adds a risk adjustment factor between 0.081 and 0.377 to a beneficiary's RAF score depending on the payment segment (0.239 for a community, non-dual, aged enrollee). 95 ICD-10-CM diagnosis codes map to HCC 249. A more severe related category (HCC 248) supersedes it when both are reported.

✓ Built from the official CMS PY 2026 risk adjustment filesV28 pays 100% of MA risk scores from PY 2026

+0.239

RAF, Community Non-Dual Aged

ICD-10-CM Codes

HCC 248

Superseded By

PY 2026

Dataset

CMS-HCC V28

RAF Weight by Payment Segment 7 segments

Payment Segment	Relative Factor
Community, non-dual, aged	0.239
Community, partial-benefit dual, aged	0.299
Community, full-benefit dual, aged	0.377
Community, non-dual, disabled	0.180
Community, partial-benefit dual, disabled	0.172
Community, full-benefit dual, disabled	0.277
Institutional	0.081

A beneficiary is scored in exactly one segment, set by Medicaid (dual) status, aged or disabled entitlement, and residence. Factors are relative weights, not dollar amounts; new-enrollee segments score on demographics only. In the hierarchy, HCC 248 (Intracranial Hemorrhage) supersedes HCC 249 when reported together.

ICD-10-CM

ICD-10-CM Codes That Map to HCC 249 95 codes

95 of 95 shown

I63.00 Cerebral infarction due to thrombosis of unspecified precerebral artery from V24 HCC 100
I63.011 Cerebral infarction due to thrombosis of right vertebral artery from V24 HCC 100
I63.012 Cerebral infarction due to thrombosis of left vertebral artery from V24 HCC 100
I63.013 Cerebral infarction due to thrombosis of bilateral vertebral arteries from V24 HCC 100
I63.019 Cerebral infarction due to thrombosis of unspecified vertebral artery from V24 HCC 100
I63.02 Cerebral infarction due to thrombosis of basilar artery from V24 HCC 100
I63.031 Cerebral infarction due to thrombosis of right carotid artery from V24 HCC 100
I63.032 Cerebral infarction due to thrombosis of left carotid artery from V24 HCC 100
I63.033 Cerebral infarction due to thrombosis of bilateral carotid arteries from V24 HCC 100
I63.039 Cerebral infarction due to thrombosis of unspecified carotid artery from V24 HCC 100
I63.09 Cerebral infarction due to thrombosis of other precerebral artery from V24 HCC 100
I63.10 Cerebral infarction due to embolism of unspecified precerebral artery from V24 HCC 100
I63.111 Cerebral infarction due to embolism of right vertebral artery from V24 HCC 100
I63.112 Cerebral infarction due to embolism of left vertebral artery from V24 HCC 100
I63.113 Cerebral infarction due to embolism of bilateral vertebral arteries from V24 HCC 100
I63.119 Cerebral infarction due to embolism of unspecified vertebral artery from V24 HCC 100
I63.12 Cerebral infarction due to embolism of basilar artery from V24 HCC 100
I63.131 Cerebral infarction due to embolism of right carotid artery from V24 HCC 100
I63.132 Cerebral infarction due to embolism of left carotid artery from V24 HCC 100
I63.133 Cerebral infarction due to embolism of bilateral carotid arteries from V24 HCC 100
I63.139 Cerebral infarction due to embolism of unspecified carotid artery from V24 HCC 100
I63.19 Cerebral infarction due to embolism of other precerebral artery from V24 HCC 100
I63.20 Cerebral infarction due to unspecified occlusion or stenosis of unspecified precerebral arteries from V24 HCC 100
I63.211 Cerebral infarction due to unspecified occlusion or stenosis of right vertebral artery from V24 HCC 100
I63.212 Cerebral infarction due to unspecified occlusion or stenosis of left vertebral artery from V24 HCC 100
I63.213 Cerebral infarction due to unspecified occlusion or stenosis of bilateral vertebral arteries from V24 HCC 100
I63.219 Cerebral infarction due to unspecified occlusion or stenosis of unspecified vertebral artery from V24 HCC 100
I63.22 Cerebral infarction due to unspecified occlusion or stenosis of basilar artery from V24 HCC 100
I63.231 Cerebral infarction due to unspecified occlusion or stenosis of right carotid arteries from V24 HCC 100
I63.232 Cerebral infarction due to unspecified occlusion or stenosis of left carotid arteries from V24 HCC 100
I63.233 Cerebral infarction due to unspecified occlusion or stenosis of bilateral carotid arteries from V24 HCC 100
I63.239 Cerebral infarction due to unspecified occlusion or stenosis of unspecified carotid artery from V24 HCC 100
I63.29 Cerebral infarction due to unspecified occlusion or stenosis of other precerebral arteries from V24 HCC 100
I63.30 Cerebral infarction due to thrombosis of unspecified cerebral artery from V24 HCC 100
I63.311 Cerebral infarction due to thrombosis of right middle cerebral artery from V24 HCC 100
I63.312 Cerebral infarction due to thrombosis of left middle cerebral artery from V24 HCC 100
I63.313 Cerebral infarction due to thrombosis of bilateral middle cerebral arteries from V24 HCC 100
I63.319 Cerebral infarction due to thrombosis of unspecified middle cerebral artery from V24 HCC 100
I63.321 Cerebral infarction due to thrombosis of right anterior cerebral artery from V24 HCC 100
I63.322 Cerebral infarction due to thrombosis of left anterior cerebral artery from V24 HCC 100
I63.323 Cerebral infarction due to thrombosis of bilateral anterior cerebral arteries from V24 HCC 100
I63.329 Cerebral infarction due to thrombosis of unspecified anterior cerebral artery from V24 HCC 100
I63.331 Cerebral infarction due to thrombosis of right posterior cerebral artery from V24 HCC 100
I63.332 Cerebral infarction due to thrombosis of left posterior cerebral artery from V24 HCC 100
I63.333 Cerebral infarction due to thrombosis of bilateral posterior cerebral arteries from V24 HCC 100
I63.339 Cerebral infarction due to thrombosis of unspecified posterior cerebral artery from V24 HCC 100
I63.341 Cerebral infarction due to thrombosis of right cerebellar artery from V24 HCC 100
I63.342 Cerebral infarction due to thrombosis of left cerebellar artery from V24 HCC 100
I63.343 Cerebral infarction due to thrombosis of bilateral cerebellar arteries from V24 HCC 100
I63.349 Cerebral infarction due to thrombosis of unspecified cerebellar artery from V24 HCC 100
I63.39 Cerebral infarction due to thrombosis of other cerebral artery from V24 HCC 100
I63.40 Cerebral infarction due to embolism of unspecified cerebral artery from V24 HCC 100
I63.411 Cerebral infarction due to embolism of right middle cerebral artery from V24 HCC 100
I63.412 Cerebral infarction due to embolism of left middle cerebral artery from V24 HCC 100
I63.413 Cerebral infarction due to embolism of bilateral middle cerebral arteries from V24 HCC 100
I63.419 Cerebral infarction due to embolism of unspecified middle cerebral artery from V24 HCC 100
I63.421 Cerebral infarction due to embolism of right anterior cerebral artery from V24 HCC 100
I63.422 Cerebral infarction due to embolism of left anterior cerebral artery from V24 HCC 100
I63.423 Cerebral infarction due to embolism of bilateral anterior cerebral arteries from V24 HCC 100
I63.429 Cerebral infarction due to embolism of unspecified anterior cerebral artery from V24 HCC 100
I63.431 Cerebral infarction due to embolism of right posterior cerebral artery from V24 HCC 100
I63.432 Cerebral infarction due to embolism of left posterior cerebral artery from V24 HCC 100
I63.433 Cerebral infarction due to embolism of bilateral posterior cerebral arteries from V24 HCC 100
I63.439 Cerebral infarction due to embolism of unspecified posterior cerebral artery from V24 HCC 100
I63.441 Cerebral infarction due to embolism of right cerebellar artery from V24 HCC 100
I63.442 Cerebral infarction due to embolism of left cerebellar artery from V24 HCC 100
I63.443 Cerebral infarction due to embolism of bilateral cerebellar arteries from V24 HCC 100
I63.449 Cerebral infarction due to embolism of unspecified cerebellar artery from V24 HCC 100
I63.49 Cerebral infarction due to embolism of other cerebral artery from V24 HCC 100
I63.50 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebral artery from V24 HCC 100
I63.511 Cerebral infarction due to unspecified occlusion or stenosis of right middle cerebral artery from V24 HCC 100
I63.512 Cerebral infarction due to unspecified occlusion or stenosis of left middle cerebral artery from V24 HCC 100
I63.513 Cerebral infarction due to unspecified occlusion or stenosis of bilateral middle cerebral arteries from V24 HCC 100
I63.519 Cerebral infarction due to unspecified occlusion or stenosis of unspecified middle cerebral artery from V24 HCC 100
I63.521 Cerebral infarction due to unspecified occlusion or stenosis of right anterior cerebral artery from V24 HCC 100
I63.522 Cerebral infarction due to unspecified occlusion or stenosis of left anterior cerebral artery from V24 HCC 100
I63.523 Cerebral infarction due to unspecified occlusion or stenosis of bilateral anterior cerebral arteries from V24 HCC 100
I63.529 Cerebral infarction due to unspecified occlusion or stenosis of unspecified anterior cerebral artery from V24 HCC 100
I63.531 Cerebral infarction due to unspecified occlusion or stenosis of right posterior cerebral artery from V24 HCC 100
I63.532 Cerebral infarction due to unspecified occlusion or stenosis of left posterior cerebral artery from V24 HCC 100
I63.533 Cerebral infarction due to unspecified occlusion or stenosis of bilateral posterior cerebral arteries from V24 HCC 100
I63.539 Cerebral infarction due to unspecified occlusion or stenosis of unspecified posterior cerebral artery from V24 HCC 100
I63.541 Cerebral infarction due to unspecified occlusion or stenosis of right cerebellar artery from V24 HCC 100
I63.542 Cerebral infarction due to unspecified occlusion or stenosis of left cerebellar artery from V24 HCC 100
I63.543 Cerebral infarction due to unspecified occlusion or stenosis of bilateral cerebellar arteries from V24 HCC 100
I63.549 Cerebral infarction due to unspecified occlusion or stenosis of unspecified cerebellar artery from V24 HCC 100
I63.59 Cerebral infarction due to unspecified occlusion or stenosis of other cerebral artery from V24 HCC 100
I63.6 Cerebral infarction due to cerebral venous thrombosis, nonpyogenic from V24 HCC 100
I63.81 Other cerebral infarction due to occlusion or stenosis of small artery from V24 HCC 100
I63.89 Other cerebral infarction from V24 HCC 100
I63.9 Cerebral infarction, unspecified from V24 HCC 100
P91.821 Neonatal cerebral infarction, right side of brain from V24 HCC 100
P91.822 Neonatal cerebral infarction, left side of brain from V24 HCC 100
P91.823 Neonatal cerebral infarction, bilateral from V24 HCC 100
P91.829 Neonatal cerebral infarction, unspecified side from V24 HCC 100

Every code above carries the full HCC 249 weight when documented and reported on a Medicare Advantage encounter. The code link opens its full page with the complete risk adjustment card.

Questions About HCC 249

What is HCC 249 in the CMS-HCC model?

HCC 249 is CMS-HCC Category 249 (Ischemic or Unspecified Stroke) in the V28 risk adjustment model. It covers 95 ICD-10-CM diagnosis codes that raise a Medicare Advantage beneficiary's risk score when documented.

What is the RAF weight for HCC 249?

For payment year 2026, HCC 249 adds 0.239 to the RAF score of a community, non-dual, aged beneficiary. The published weights range from 0.081 to 0.377 across the seven payment segments shown above.

Which categories supersede HCC 249?

HCC 248 (Intracranial Hemorrhage) sits above HCC 249 in the hierarchy: when a beneficiary has diagnoses in both, only the more severe category is paid.

Related References

All HCC Categories HCC 248 Codes V24 to V28: What Changed ICD-10-CM Code Lookup

Source: Centers for Medicare & Medicaid Services, Payment Year 2026 risk adjustment mapping and model software releases (CMS-HCC V28), applied to the FY 2026 ICD-10-CM code set. ICD List is not affiliated with CMS.